Provider Demographics
NPI:1881248441
Name:NEW AGE HOSPICE PALLIATIVE, LLC
Entity type:Organization
Organization Name:NEW AGE HOSPICE PALLIATIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-390-4040
Mailing Address - Street 1:2200 SPACE PARK DR STE 405
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3680
Mailing Address - Country:US
Mailing Address - Phone:832-369-6970
Mailing Address - Fax:866-355-7913
Practice Address - Street 1:2200 SPACE PARK DR STE 405
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3680
Practice Address - Country:US
Practice Address - Phone:832-369-6970
Practice Address - Fax:866-355-7913
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW AGE HOSPICE PALLIATIVE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-31
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019594OtherLICENSE
TX971606OtherACHC